Questions remain after judge lifts age limit on Plan B

A judge's recent lifting of age restrictions on the purchase of Plan B One-Step, an emergency contraceptive, has left Chicago-area health care providers and residents unclear on what actions to take.

A judge's recent lifting of age restrictions on the purchase of Plan B One-Step, an emergency contraceptive, has left Chicago-area health care providers and residents unclear on what actions to take. (E. Jason Wambsgans, Chicago Tribune)

With a federal judge clearing away age restrictions on purchasing emergency contraception, many Chicago-area health care providers, teens and others are preparing for more accessibility — even if they're not exactly sure how the drug will be made available.

Major medical groups praised the ruling of U.S. District Judge Edward Korman, who this month lifted the ban that prevented anyone younger than 17 from buying Plan B One-Step and its generic versions without a prescription. The drug can prevent pregnancy if taken shortly after sexual intercourse, preferably within 24 hours.

The Obama administration has until early Mayto decide whether it will appeal the decision. If the federal ruling is not overturned, younger consumers will be able to purchase the morning-after pill anywhere it's sold — including supermarkets and convenience stores, alongside pain medication and over-the-counter contraceptives.

Until then, restrictions still apply. At chains such as Walgreens, CVS and Target, that means the product remains off store shelves and is instead kept behind pharmacists' counters, where they will ask for proof of age before selling it.Those 16 or younger must also still provide a prescription.

"Until the Food and Drug Administration issues new directions, there is no change to (our) sales and dispensing policies for this medication," said Carolyn Castel, a spokeswoman for CVS Caremark.

The FDA declined comment, calling it "a legal matter." As of Tuesday there had been no word on whether the administration plans to appeal the decision, according to Allison Price, a spokeswoman for the Department of Justice.

The 30-day appeal window ends May 5.

Since Plan B was approved in 1999, it has been entangled in controversy. It works by blocking ovulation — not by causing an abortion — and no pregnancy test is required, physicians say.

Last year, Plan B generated $82.6 million in sales, followed by Next Choice with $56.3 million, according to IMS Health, a health care technology and information company.

"While pediatricians recommend that teens delay sexual activity until they fully understand its consequences, we strongly encourage the use of contraception — including emergency contraception — to protect the health of our adolescent patients who are sexually active," Dr. Thomas McInerny, president of the academy, said after the new ruling.

However, Dr. Donna Harrison, executive director of the American Association of Pro-Life Obstetricians and Gynecologists, called lifting the ban "a very foolish move."

"This drug has not been studied for safety for girls 16 and under," Harrison said. "We have no studies on the long-term effects of unlimited and unsupervised ingestion of hormones."

There are other reasons the association would like to see restricted access continue, including that it separates young people from medical care. "You miss an opportunity to intervene. ... It just defies sense," she said.

The number of U.S. births per 1,000 females ages 15 to 19 years old is 34.3 — the lowest since the federal Centers for Disease Control and Prevention started keeping records in the 1940s. It's a sign that fewer restrictions and more comprehensive sexual education programs are working, said Bill Albert of the National Campaign to Prevent Teen and Unplanned Pregnancy.

Still, there's much work to be done, advocates say. Of the estimated 10,150 teen births in Illinois in 2010, almost half were to girls age 17 and younger, the CDC reports.

"Contraception doesn't always follow a 9-to-5 clock," Albert said, noting that rural areas, where teen pregnancy rates are among the highest, may have limited accessibility. "And when you're 16, going to a pharmacy can be pretty intimidating."

Numerous studies show that adults discussing the value of delaying sex and the importance of contraception with their teenagers does not hasten the onset or increase the number of sexual partners.

The Tribune spoke with some teens about the possibility that the pill may soon be available without a prescription.

"I think it's a really good idea," said Sydni Johnson, a senior at Homewood-Flossmoor High School, on lifting the age ban on the morning-after pill. "What difference does a year or two make if you're planning to have sex? It's better to be safe than sorry."

Josie Reed, a nurse in the south suburbs, agrees. "Kids need information … including if there are any adverse effects to the drug," she said.

By making the drug available, "you're not condoning sex, you're giving them options to protect themselves," Reed said.

But Karen Brauer of Pharmacists for Life said consent is precisely the message youths would be given if the drug is made more available.

It would be "saying sex is a foregone conclusion," said Brauer, who is based in Indiana. "It's not good for society."

In a 2012 survey commissioned by the National Campaign to Prevent Teen and Unplanned Pregnancy, teens said parents — not peers or availability of contraceptives — most influenced their decisions about sex.

"What is the most helpful thing my parents told me about sex? I wouldn't know," said a 17-year-old who participated in the survey. "My parents never talked to me. That's why I am now a dad."